Miliaria (miliaria rubra—sweat rash or prickly heat) is a skin disease marked by small and itchy rashes. Miliaria is a common ailment in hot and humid conditions, such as in the tropics and during the summer season. Although it affects people of all ages, it's especially common in children and infants due to their underdeveloped sweat glands. Miliaria occurs when the sweat gland ducts get plugged due to dead skin cells or bacteria such as Staphylococcus epidermidis, a common bacterium that occurs on the skin that is also associated with acne. The trapped sweat leads to irritation (prickling), itching and a rash of very small blisters, usually in a localized area of the skin.
Causes of Heat Rash
Heat rash is easy to treat. If you look at it very closely, you'll see little red dots: these are sweat glands that have become inflamed at the opening. With further exposure to heat, there will also be a prickly 'pins and needles' sensation on the skin, which is why it's called prickly heat.
The most commonly encountered form of the illness is miliaria rubra, in which obstruction causes leakage of sweat into the deeper layers of the epidermis, provoking a local inflammatory reaction and giving rise to the typical appearance of redness (hence rubra) and larger (but still only a few millimetres) blister-like lesions. This form of the illness is often accompanied by the typical symptoms—intense itching or "pins and needles" with a lack of sweating (anhidrosis) to affected areas. There is a small risk of heat exhaustion due to inability to sweat if the rash affects a large proportion of the body's surface area and/or the sufferer continues to engage in heat-producing activity.
Treatment of Heat Rash
Basic Treatment
- Avoid sweating. Since prickly heat occurs when the sweat ducts are blocked and sweat leaks into the skin, the only way to reverse it is to be in a situation where you won't sweat for a while. Spend as much time as you can inside a building that has air conditioning. Wear loose clothing made from cotton or polypropylene and avoid nylon, polyester or any tight-fitting clothes— anything that will wick moisture away from the body and keep the skin dry.
- Wash with soap. To avoid the worst of heat rash, wash with a mild, antibacterial soap. Dial or Lever 2000 are recommended, followed by a thorough rinsing and drying. Also, Cornstarch (used in baking) is excellent for helping keep your skin dry and doesn't have the perfumes that will irritate your rash even further.
- See a doctor as soon as a rash appears. Medical assistance should be sought for the first episode of a rash with the appearance of miliaria. The differential includes several conditions that an experienced practitioner should be able to recognize and may require treatment distinct from the usual measures taken for miliaria. In most cases, the rash of miliaria will be resolved without intervention. However, severe cases can last for a number of weeks and cause significant disability. General measures should be recommended for all patients, including moving to an air-conditioned environment if possible, avoiding sweat-provoking activities and occlusive clothing.
- Use antihistamines. Usually, rashes and hives are caused by the same thing—the body’s release of histamines and the skin’s reaction to those histamines. Antihistamines like Benadryl are the obvious solution to a problem with hives. A rash on your skin is your body’s way of telling you that it’s fighting something you’re allergic to or something foreign on your skin. Nevertheless, try a homeopathic medicine called urtica urens first before giving antihistamines a shot. Get a 30c strength from the chemist and suck one twice a day—that should work within two or three days and might actually solve the problem. It's safe and free of any side effects.
- Use talcum powder. Heat rash comes from high temperatures, moist skin and friction. Talcum powder will dry the skin. Apply liberally over the areas, probably 3 to 8 times a day. Keep the area dry and it will clear up in a couple of days.
- Use topical antibacterials. It has been suggested that the use of topical antibacterials (including the use of antibacterial soaps) may shorten the duration of symptoms in miliaria rubra even in the absence of obvious superinfection. Other topical agents that may reduce the severity of symptoms include anti-itch preparations such as calamine or menthol and/or camphor-based preparations and topical steroid creams. However, caution should be used with oil-based preparations (ointments and oily creams as opposed to water-based or aqueous lotions) that may increase blockage to the sweat glands and prolong duration of illness.Other agents have been investigated, including supplemental Vitamin A and C and Vitamin-A-based medications, but it's worth noting that there's little scientific evidence supporting any of the above treatments in terms of actually reducing the duration of symptoms or frequency of complications.
- Don't touch the rash and keep it moist. The best thing you can do to get rid of a rash is not to touch it and keep it moisturized. A lot of the times when people have a rash, they make it worse by scratching or picking at it. What you want to do is protect the skin that's affected by the rash. Try not to scratch the rash, and if the skin around the rash starts to scale, you should put some moisturizer on it to help keep the skin hydrated. Make sure to use a moisturizer that’s water-based rather than oil-based.
- Avoid the sun. If you’re serious about getting rid of your heat rash, you’re going to have to stay out of the sun and wash yourself with gentle or natural soaps. Seriously, staying out of the sun will avoid making rashes worse. If you can't avoid going out, at least use sun block. Regardless of your daily Vitamin D requirements, too much of anything is bad, and that includes overexposure to sunshine.
- See a doctor for advanced cases of rash. In cases where the rash has developed into open blisters or pustular lesions, a doctor should be consulted, because other less benign conditions should be considered and/or more aggressive treatment may be required.
Home Remedies
- Use jewelweed. Jewelweed is one of those natural remedies for heat rashes that just keeps on popping up. According to the Green Pharmacy Herbal Handbook, the juices from the reddish protuberances extending out from the lower stem of a jewelweed (as opposed to the leaves) are best, especially if applied soon after the heat rash outbreak starts.
- Get an oatmeal bath. The oatmeal bath is perhaps one of the most popular natural remedies for rashes and other bouts of dermatitis (infections of the skin). How you go about applying the boiled oatmeal to your skin (not while boiling, hopefully) is up to you. Many suggest boiling it in a sock or a rag and using it as you would use a loofah in a cool tub of water—no soap.
- Use aloe. Aloe is the most popular skin moisturizing treatment on the market today. You’ll find aloe in just about everything, including commercial rash treatments. On its own, it’s a steroid-free, cooling moisturizer that should be applied regularly to keep the rash moist and comfortable.
- Use cocoa butter. Cocoa butter is one of those wonderful creams you can use to help keep that rash moisturized during the day. People use this stuff for treating hives, and it's highly recommended for treating other forms of rashes as well.
Heat rashes and prickly heat are treatable conditions of little to no consequence save for those with the most sensitive or skin. Just remember to make use of these tips and information before it's too late. Also take note that if your rash persists for longer than ten days or is accompanied by any other symptoms, you should inform your physician immediately. Also note that wildfire is a bit more complicated than your run-of-the-mill heat rash, and may need professional dermatological treatment.
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